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Published on: June 26, 2013
Factors correlated with NPPV use in ALS
Carlayne E Jackson1, Steven Lovitt, Neelam Gowda
1University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA. jacksonce@uthscsa.edu
Summary
Many ALS patients don't use non-invasive positive pressure ventilation (NPPV). Symptoms like shortness of breath and difficulty breathing upright strongly correlate with NPPV use in ALS patients.
Area of Science:
- Neurology
- Pulmonology
- Medical Technology
Background:
- Non-invasive positive pressure ventilation (NPPV) shows therapeutic promise for Amyotrophic Lateral Sclerosis (ALS) patients.
- Despite evidence of benefit, NPPV adoption among ALS patients remains low.
Purpose of the Study:
- To investigate factors associated with NPPV utilization in ALS patients.
- To identify predictors of NPPV use to understand its underutilization.
Main Methods:
- Analysis of data from the ALS CARE Database.
- Inclusion criteria: probable/definite ALS (El Escorial criteria) with forced vital capacity (FVC) <50% predicted.
- 403 eligible patients were assessed for NPPV use.
Main Results:
- 146 out of 403 (36%) eligible ALS patients used NPPV.
- NPPV use strongly correlated with dyspnea and orthopnea symptoms.
- Use of PEG tubes, augmentative speech devices, and riluzole also correlated with NPPV use.
- Higher household income (>$80,000) and male gender were associated with increased NPPV use.
- No correlation found with age, race, insurance, FVC, symptom duration, ALSFRS-R, caregiver burden, or quality of life.
Conclusions:
- Symptomatic orthopnea and dyspnea are key factors driving NPPV utilization in ALS.
- Findings suggest potential targets for improving NPPV adoption and optimizing its use in ALS care.
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